Aborting the Imperfect: Welfare State Ethics at Work

Three months ago I reported on a very disturbing “advancement” in medical ethics. Two so called ethicists published an article in a the renowned scholarly Journal of Medical Ethics where they openly advocated infanticide in order to contain the costs of health care for children with medical “abnormalities”.

It is worth noticing that their analytical framework was one where government runs the entire health care system – a single-payer system, in other words. Today we can report about other assaults on life in the name of cost containment. With my translation the Swedish news site Världen Idag (World Today) reports that tax-paid abortion is being used by parents in Denmark and Britain as a means to discard babies with cleft palate:

The disability is not life threatening. But in the quest for the perfect the Danish couple chose abortion. The baby they were expecting had cleft palate. In England 26 babies have been aborted for the same reason – one in the 28th week of the pregnancy.

In my article on the infanticidial medical “ethicists” I pointed to how they used babies with Downs Syndrome as an argument for precisely that – infanticide. They suggested that since not all cases can be diagnosed during the pregnancy, parents should be allowed to kill their children if they are diagnosed with that condition after birth.

According to Världen Idag, access to free, tax-paid abortion has already significantly reduced the number of babies who are born with downs Syndrome in Denmark:

In Denmark there is no room for children with Downs Syndrome. Unborn babies with this chromosome abnormality are aborted almost without exception … . But now this practice has expanded in a world with growing intolerance toward that which is not perfect. Every year almost 500 pregnant women in Denmark apply to have an abortion after ther 12th week – which is the Danish limit for free abortion – because the baby they are carrying has a medical condition or a disability. In most cases the condition is so serious that the child has a very small chance to survive. However, the abortion is far from always in response to [the child having a] life threatening condition. Recently the national newspaper Politiken reported that unborn babies are being discarded after having been diagnosed with medical conditions with which they can live a long life, provided they get the right treatment.

Let’s stop and remember for a moment who is paying for this treatment. Technically, of course, that would be the parents of the child, but they do it over their tax bill. Instead of making the parents directly responsible for the abortion decision, the single-payer health care system puts bureaucrats in charge. Their primary concern is not to provide as much health care to as many people as possible, but to contain the costs of the government-run health care system. (For anyone in doubt that this in fact the case, please click here.)

Because politicians and bureaucrats in a country with single-payer health care are first and foremost concerned with keeping the costs of health care down, they will find ways to convince parents of unborn babies with medical “abnormalities” to consider an abortion. Their ethical backup comes from modern-day fiscal eugenicists.

Back now to the Swedish news site, which reports that of 488 applications for late term abortion in Denmark in 2011,

…only eleven were denied, while 118 applications to abort a baby with Downs Syndrome were approved. In the remaining cases the majority was about conditions that were so serious that the child would probably not have survived birth. But the report also shows an other, emerging trend. The [Danish paper Politiken] reports, e.g., about 13 unborn babies who were diagnosed with Turner’s and Klinefelter’s Syndrome, who were also aborted. Both diseases are caused by chromosome abnormalities … and affect among other things growth, the production of hormones and the ability to have children.

Apparently, children with both these conditions now have a relatively good outlook on life, thanks to advancements in medicine. But the tendency to abort them is not driven by the advancements in medicine – it is driven by advancements in the need to contain costs in socialized medicine. With those needs come a social and cultural climate that is harsher, stingier and more unforgiving toward abnormalities that:

a) increase the individual citizen’s need for medical care throughout her life span, and

b) decrease her ability to work and be a taxpayer.

Again, in my book Remaking America: Welcome to the Dark Side of the Welfare State I chronicle numerous cases of how government forces people with serious medical conditions – including leukemia – back to work, in part because government cannot afford their health care, in part because government wants to get them off government income security and back to being taxpayers. To the lawmakers in Sweden, government finances are more important than the well-being of the people.

Back to the Världen Idag story:

However, using cleft palate as a reason for abortion is not an isolated phenomenon. Last year, data on how many babies had been aborted – and especially for what reasons – sent shock waves through Britain. The publication [of the data] followed a long legal battle spearheaded by the Pro Life alliance. It started when Joanna Jepson, priest in the Anglican Church, went to the Supreme Court with a case of a baby that was aborted in 2001 at the 28th week of pregnancy due to cleft palate.

Rev. Jepson was herself born with cleft palate and underwent successful surgery. She used this case to illustrate what she defined as “a culture of perfection. To prove this, she and the Pro Life Alliance sued the British Department of Health to obtain data over the reasons having been given for abortions. The government agency refused to release the numbers, claiming that the observations were so few that the women could be identified from them. After six years of litigation the Alliance won:

It turned out that 26 babies with cleft palate had been aborted over a nine-year period, seven of them in 2010. That same year, 147 babies were aborted after the 24th pregnancy week. … Twelve of the aborted babies had myelomeningocele (spina bifida), eight had club foot, ten had Downs Syndrome and as many had Edward’s Syndrome, also a chromosome abnormality.

At the core of every government-run health care system is a calculation on whether or not every citizen will be a net taxpayer or net entitlement consumer over his life span. Because of notorious health care rationing under government, there is never enough resources to treat everyone for every health condition they need. Government finds itself in the predicament of having caused a rationing situation that leads to decisions on who gets health care and who does not. (Which is why there are Death Panels in the Affordable Care Act.) One variable considered in such calculations is the net cost to government of saving Jack vs. saving Joe. Suppose they have the same life-threatening condition, and Jack will live long enough to pay enough taxes throughout the rest of his life to make up for the cost of the treatment. Suppose that Joe in all likelihood won’t. All other things equal, government then decides to give the treatment to Jack and let Joe die.

The same principle applies to the abortion of babies with so called medical abnormalities. For now, government in countries with government-run health care cannot force women into abortion, but it can persuade them. There is anecdotal evidence that this is in fact the case in, e.g., Sweden. (I am collecting more of these anecdotes to show a well established pattern.) But if government cannot keep its costs under control, forced “abnormality” abortions may become a reality at some point.